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ロボットアシスト,コンピュータアシスト,および手動の全関節整形手術における入院中のオピオイド摂取:遡及的なコホート研究
Periklis Giannakis1,2, Juliet E Rowe1, Renee Ren1
1Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
BJA open
|February 13, 2026
まとめ
コンピュータ支援およびロボット支援の整体股関節整形術 (THA) は,手動のTHAよりも,特に手術後の1日目に,オピオイドの消費量が低いことを示しました. これらの発見は,疼痛管理のための技術支援のTHAの潜在的な利点を示唆しています.
科学分野:
- 整形外科 整形外科
- 疼痛管理 疼痛管理
- 医療情報工学 医療情報工学
背景:
- オピオイドの摂取は,総関節整形手術 (THA) の後の大きな懸念事項です.
- マニュアル (MA-THA),コンピュータアシスト (CA-THA),ロボットアシスト (RA-THA) を含むさまざまな外科的アプローチは,術後の痛みとオピオイド使用に影響を与える可能性があります.
研究 の 目的:
- 入院中のオピオイドの総消費量をMA-THA,CA-THA,RA-THAで比較する.
- 特定の術後日にオピオイド使用に対する外科技術の影響を評価する.
主な方法:
- プレミア・ヘルスケアデータベース (2016-2023) を用いた遡及コホート研究.
- 584,578人の患者の分析で,一方的な選択的THA.を投与した.
- オピオイド使用 (はい/いいえ) と使用者間の消費を評価する2部構成の混合効果モデル.
主要な成果:
- CA-THAは,MA-THA (OR,0.87) よりもオピオイドの使用率が低いと関連していました.
- RA-THAは,CA-THA (OR,1.22) よりもオピオイドの使用率が高く示されました.
- CA-THAとRA-THAの両方が,使用者の間でMA-THAよりも2%低いオピオイドの総摂取量に関連していました. 術後1日目には,MA-THAと比較してCA-THAとRA-THAの両方の有意な減少が認められました.
結論:
- テクノロジーアシストされたTHA (CA-THAとRA-THA) は,MA-THAと比較して,特に早期の術後の期間に,オピオイド消費量の減少と関連しています.
- 意思決定を変えるほど臨床的に有意ではないが,観察された差異は,手術後の直後の痛みを軽減する改善された麻酔技術に関連している可能性がある.
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